Conference Coverage

Clinic goes to bat for bullied kids


 

EXPERT ANALYSIS FROM AAP 2019

The consequences of bullying

The psychological and educational consequences of bullying among children in general include being more likely to develop depression, loneliness, low self-esteem, alcohol and drug abuse, sleeping difficulties, self-harm, and suicidal ideation and attempts. “We’re social creatures, and when we don’t have those social connections, we get very depressed.”

Bullying victims also are more likely to develop school avoidance and absence, decreased school performance, poor concentration, high anxiety, and social withdrawal – all of which limit their opportunities to learn. “The No. 1 thing you can do to help these kids is to believe their story – to explain to them that it’s not their fault, and to explain that you are there for them and that you support them,” he said. “When a kid gets the feeling that someone is willing to listen to them and believe them, it does an enormous good for their emotional state.”

Dr. Peter C. Raffalli, director, Boston Children's Hospital Bullying and Cyberbullying Prevention and Advocacy Collaborative. Doug Brunk/MDedge News

Dr. Peter C. Raffalli

Dr. Raffalli added that a toxic stress response can occur when a child experiences strong, frequent, and/or prolonged adversity – such as physical or emotional abuse, chronic neglect, caregiver substance abuse or mental illness, exposure to violence, and/or the accumulated burdens of family economic hardship – without adequate adult support. This kind of prolonged activation of the stress response systems can disrupt the development of brain architecture and other organ systems, and increase the risk for stress-related disease and cognitive impairment well into the adult years.

In the Harvard Review of Psychiatry, researchers set out to investigate what’s known about the long-term health effects of childhood bullying. They found that bullying can induce “aspects of the stress response, via epigenetic, inflammatory, and metabolic mediators [that] have the capacity to compromise mental and physical health, and to increase the risk of disease.” The researchers advised clinicians who care for children to assess the mental and physical health effects of bullying (Harv Rev Psychiatry. 2017;25[2]:89-95).

Additional vulnerabilities for bullying victims include parents and children whose primary language is not English, as well as parents with mental illness or substance abuse and families living in poverty. “We have to keep in mind how much additional stress they may be dealing with. This can make it harder for them to cope. Bullies also are shown to be at higher risk for psychological and legal trouble into adulthood, so we should be trying to help them too. We have to keep in mind that these are all developing kids.”

Cyberbullying

In Dr. Raffalli’s clinical experience, cyberbullying has become the bully’s weapon of choice. “I call it the stealth bomber of bullying,” he said. “Cyberbullying can start as early as the second or third grade. Most parents are not giving phones to second-graders. I’m worried that it’s going to get worse, though, with the excuse that ‘I feel safer if they have a cell phone so they can call me.’ I tell parents that they still make flip phones. You don’t have to get a smartphone for a second- or third-grader, or even for a sixth-grader.”

Recommended Reading

Letters From Maine: Adult ADHD is on the rise
MDedge Pediatrics
Conduct disorder in girls gets overdue research attention
MDedge Pediatrics
More adolescents seek medical care for mental health issues
MDedge Pediatrics
Helping adolescents get enough quality sleep
MDedge Pediatrics
Suicide screening crucial in pediatric medical settings
MDedge Pediatrics
An alarming number of bipolar disorder diagnoses or something else?
MDedge Pediatrics
ACGME deepening its commitment to physician well-being, leader says
MDedge Pediatrics
Higher risk of bipolar disorder, depression, anxiety found with autism
MDedge Pediatrics
Social anxiety more likely with inattentive ADHD, psychiatric comorbidities
MDedge Pediatrics
Poor sleep due to ADHD or ADHD due to poor sleep?
MDedge Pediatrics